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General NPI Number Information
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NPI Number | 1427326321
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Entity Type | Organization
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Legal Business Name | BETH ABATE NURSE PRACTITIONER LLC
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Dates
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Enumeration Date | 12/06/2011
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Last Update Date | 09/21/2022
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Provider Practice Location Address
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Address Line | 6910 MAYFAIR RD
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City | LAUREL
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State | MD
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Zip | 20707-5237
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Country | US
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Telephone | 240-447-9995
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Fax | 240-363-0063
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Provider Business Mailing Address
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Address Line | 14625 BALTIMORE AVE STE 465
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City | LAUREL
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State | MD
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Zip | 20707-4902
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Country | US
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Telephone | 240-447-9995
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Fax | 301-776-0087
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Authorized Official
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Title or Position | OWNER
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Name | BETELEHEM ABATE
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Credential | APRN
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Telephone | 240-447-9995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN965723
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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